Bombings specific triage (Bost Tool) tool and its application by healthcare professionals

doi:10.5847/wjem.j.1920-8642.2015.04.007

Abstract

Abstract:

BACKGROUND: Bombing is a unique incident which produces unique patterns, multiple and occult injuries. Death often is a result of combined blast, ballistic and thermal effect injuries. Various natures of injury, self referrals and arrival by private transportation may lead to "wrong triage" in the emergency department. In India there has been an increase in incidence of bombing in the last 15 years. There is no documented triage tool from the National Disaster Management Authority of India for Bombings. We have tried to develop an ideal bombing specific triage tool which will guide the right patients to the right place at the right time and save more lives.
METHODS: There are three methods of studying the triage tool: 1) real disaster; 2) mock drill; 3) table top exercise. In this study, a table top exercise method was selected. There are two groups, each consisting of an emergency physician, a nurse and a paramedic.
RESULTS: By using the proportion test, we found that correct triaging was significantly different (P=0.005) in proportion between the two groups: group B (80%) with triage tool performed better in triaging the bomb blast victims than group A (50%) without the bombing specific triage tool performed.
CONCLUSION: Development of bombing specific triage tool can reduce under triaging.

Key words: Bombing, Blast Injuries, Terrorist Bombings, Triage

Jaiswal Sanjay, Verma Ankur, Kole Tamorish. Bombings specific triage (Bost Tool) tool and its application by healthcare professionals[J]. World Journal of Emergency Medicine, 2015, 6(4): 289-292.

Figures/Tables 7

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Table 1

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References 9

1	Wolf SJ, Bebarta VS, Bonnett CJ, Pons PT, Cantrill SV. Blast injuries. Lancet 2009; 374:405-415. doi: 10.1016/S0140-6736(09)60257-9. Epub 2009 Jul 22. doi: 10.1016/S0140-6736(09)60257-9 pmid: 19631372
2	de Ceballos JP, Turégano-Fuentes F, Perez-Diaz D, Sanz-Sanchez M, Martin-Llorente C, Guerrero-Sanz JE. 11 March 2004: The terrorist bomb explosions in Madrid, Spain--an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital. Crit Care 2005; 9: 104-111. Epub 2004 Nov 3.
3	Goh SH. Singapore Med J 2009; 50:101-106. pmid: 19224092
4	Mayo A, Kluger Y. Terrorist bombing. World J Emerg Surg 2006; 1:33.
5	Aharonson-Daniel L, Klein Y, Peleg K; ITG. Suicide bombers forma new injury profile. Ann Surg 2006; 244:1018-1023. pmid: 17122628
6	Guscott WM, Guscott AJ, Malingambi G, Parker R. The Bali bombings and the evolving mental health response to disaster in Australia: lessons from Darwin. J PsychiatrMent Health Nurs 2007; 14:239-242.
7	Jenkins JL, McCarthy ML, Sauer LM, Green GB, Stuart S, Thomas TL, et al. Mass-casualty triage: Time for an evidence-based approach. Prehospital Disast Med 2008; 23:3-8. doi: 10.1017/S1049023X00005471
8	Hodgetts TJ, Mackway-Jones K. Major incident medical management and support: the practical approach. London: BMJ Publishing, 1995.
9	Garner A, Lee A, Harrison K, Schultz CH. Comparative analysis of multiple-casualty incident triage algorithms. Ann Emerg Med 2001; 38:541-548. pmid: 11679866

Groups	OT	CT	UT
A without tool	8	15	7
B with tool	3	26	1

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